Acromioclavicular Joint Reconstruction

Abstract

Our technique for acromioclavicular joint reconstruction provides a variation on coracoclavicular ligament reconstruction to also include acromioclavicular ligament reconstruction. An oblique acromial tunnel is drilled, and the medial limb of the gracilis graft, after being crossed and passed beneath the coracoid and through the clavicle, is passed through this acromial tunnel and sutured to the trapezoid graft limb after appropriate tensioning. Tenodesis screws are not placed in the bone tunnels to avoid graft fraying, and initial forces on the graft are offloaded with braided absorbable sutures passed around the clavicle.

Biplanar fixation of acromio-clavicular joint dislocation associated with coracoid process fracture: Case report

“…trans -Articular wires had been described by many authors to manage combined AC dislocation and CP fracture [ 3 ], This technique carries the risk of hardware migration, breakage and need for removal [ 8 ], A more stable fixation using hook plate for AC stability alone [ 3 ] or in combination with CP fixation using cannulated screws also was described [ 9 ], but again this technique had high complication rates including shoulder pain and discomfort that is only relieved after plate removal [ 8 ].…”

All-Arthroscopic Coracoclavicular Ligament Reconstruction Surgical Technique Using a Semitendinosus Allograft and Tenodesis Screws

“…2 When surgical treatment is indicated, the primary goals of a CC ligament reconstruction are to restore anatomic reduction of the AC joint and reconstruct the biomechanical forces of the CC ligaments. 3 Many open surgical techniques are currently used to achieve these goals. These techniques may use screw fixation, a button with a TightRope (Arthrex, Naples, FL), suture anchors, or an acromial hook plate.…”

“…These techniques may use screw fixation, a button with a TightRope (Arthrex, Naples, FL), suture anchors, or an acromial hook plate. 3,4 Other techniques use free tendon grafts (frequently semitendinosus allograft or autograft) for open reconstruction of the CC ligament, with the use of internal fixation into the distal clavicle to anatomically reinforce the tendon construct. 2,5 We describe a technique for an all-arthroscopic CC ligament reconstruction using a semitendinosus allograft and BioComposite tenodesis screws (Arthrex) without disruption of the deltoid attachment onto the distal clavicle (Video 1).…”